Clinical analysis of pharmacologic leukopenia and agranulocytosis

CAI Cheng-cai

doi:10.3760/cma.j.issn.1673-4777.2012.04.017

Abstract：Objective By describing the clinical manifestation of a group of commonly used medicines causing pharmacologic leukopenia and agranulocytosis,obtain a better understanding of damage to the blood system by medicines,call attention to rational medication and increase the pharmic safety.Methods Retrospectively analyze the clinical data of the 66 patients of the Department of Hematology in my working hospital from January 1990 to December 2010.Results Among the 66 patients,ADR of 16(24.2％ ) were caused by thyroid function of hyperthyroidism medicine,9( 13.6％ ) by antibacterial drugs,9( 13.6％ ) by antipsychotic drugs,9( 13.6％ ) by antiepileptic drugs,6(9.1％ ) by anti-rheumatoid arthritis drugs,4(6.1％ ) by drugs treating gout,3(4.5％ ) by glucoselowering drugs,3(4.5％ ) by drugs treating systemic lupus erythematosus skin damage,2(3％ ) by drugs treating stomach,duodenum ball department ulcer,2 (3 ％ ) by antipyretic analgesics,2 (3％) by anti-estrogen drugs used to prevent recurrence after mastectomy,1 (1.5％) by proprietary Chinese medicine preparation treating toothache.The clinical manifestation showed white blood cells decreased (54 cases,81.8％ ),agranulocytosis (12 cases,18.2％ ),bone marrow hematopoietic function stagnation(3 cases,4.5％ ),high fever(23 cases,34.8％ ),skin damage( 10 cases,15.1％ ),various secondary infections(58 cases,89％ ),agonal infections( 10 cases,15.1％ ),septic shock ( 3 cases,4.5 ％ ),fungal sepsis (2 cases,3 ％ ),liver failure ( 1 case,1.5 ％ ),renal failure ( 1 case,1.5％ ),and 3deaths(4.5％ ).Conclusion We should think much of the pharmic safety owing to the fact that some commonly used medicines can cause slow or sharp decrease of white blood cells or agranulocytosis and various infections follow.Those can lead to sharp change in the patients' conditions or even take their lives.